Fastener



Sept. 13, 1960 G. J. KEATING I FASTENE'R Filed Nov. 6, 1958 INVENTOR.GEORGE J. KEATING ATTORNEY 2,952,254. FASTENER George J. Keating, 10865Calavo Drive, La Mesa, Calif. Filed Nov. 6, 1958, Ser. No. 772,243

Claims. (Cl. 128-92) invention relates generally to fasteners and moreparticularly tonail devices used in the treatment of bone fractures.

An objectof the present invention is to provide a novel form of nailingassembly having a: construction which adapts ,it for use in treatinghipfractures. by securing broken bone portions together in effectivelyfixed relationship.

Another object :ofthis invention is to provide an improved nail assemblyfor. holding broken bone portions together which acts in a manner toachieve compression atthe opposing fracture surfaces.-

Another object resides in providing an improved form of hip nailassembly for treating a femoral neck fracture wherein the cooperatingelements of the nailv assembly. serve to effect opposing compressionforces directly across the fracture site.

Another object is to provide ahip nail. assembly which is simple inconstruction, which can be readily placed. in operative position, andwhich is efficient in action.

Other objects and features of the present invention will 4 3 be readilyapparent to those skilled in the art from the following specificationand appended drawing wherein is illustrated a preferred formof theinvention and in which:

Figure 1 is an exploded view of a nail assembly having a construction inaccordance with this invention.

Figure 2 is a sectional view showing the presentnail assembly inoperative position in treating a femoral neck fracture; and

Figure 3 is a side elevational view of a detail.

Referring now with particularity to the drawings the. nail assembly ofthe present invention is indicated therein in its entirety by thenumeral 10.

Nail assembly 10, as shown, embodies: a central pin-or stem portion 11,a sleeve or jacket member- 12, an anchor plate 13 and a usualdome-shape, self-locking nut 14.

Central pin 11.is of cylindrical form for the major portion of itslength and tapers to a conical point 15 at its lower end. A threadedportion 16 is provided at, its

other end for accommodation ofthe nut 14. .Extending v helically fromthe lower cylindrical end of the. pin 11 and I substantially. the entirelength of conical portion,.15' an external lag-screw thread 17,.Whichisformed into? grally with pin 11. A transverse through opening '18 isprovided at the upper end of pinllifor accommodating a suitable tool. torotate and screw pin ll into place.

The sleeve or jacket member 12 embodies an elongated generallycylindrical body portion 19 having an axial bore 20 of adiameter-suflicient topermit the. passage-of pin 11 therethrough. Inequi-spaced relationship about the circumference of body portion 19 arethree longitudinally extending flanges 21. Flanges 21, preferably,arejformed integral withbody portion 19 andare of the same lengththereas. Flanges 21, as shown; are of substantially rectangularconfiguration andhave their lower lateral edges shaped into-the form ofchisel edges as at 22. Lower annualnim 26. ofbodyportion 19 whichisadjaice 2. cent chisel edges 22 is also shaped to provide a cutting orchisel edge.

Anchor plate 13 is a generally rectangular metal piece which has beenbent into a contour adapting it to rest firmly upon the femur when inplace andincludes a central aperture 24 for accommodating the pin 11.Plate 13 also includues a plurality of integral pointed attaching prongs25 which depend from the body of the plate. In

the embodiment illustrated the prongs are four in number with a pairbeing disposed on opposite lateral edges 26 and 27 of the plate. Asshown, the pair of prongs 25 on lateral edge 26 are spaced somewhatcloserv together than the pair on lateral edge'27. This staggering ofthe prongs serves to lessen the possibility of. longitudinal cracksbeing formed in the bone.

The pin 11', jacket 12 and anchor plate 13 may be made of any suitablehard metal. course, that the metal used be one which has little tissuereaction. However, the invention is not to be restricted to any one formor type of metal since satisfactory metals are commercially availableand since a particular metallic composition does not form a part of thisinvention. For instance, chromium-nickel stainless steels may beemployed in the present invention, an example being 1885 MO'stainlesssteel.

In Figure 2 there is illustrated the upper portiono-f a femur A to whichthe presentinvention has been applied for treatment of a fracturethereof indicated at B.- Fraccure B, as shown, extends across femoralneck C of the femur.

In the treatment of a fracture, the pin 11 of thev nailassembly 19 isinserted first. However, prior to placement of the pin 11 a guide holeis formed toassist in its proper placement. To this end a suitable tool,such as a drill, is employed to form. an-angularly disposed guide holewhich starts at a point suitably spaced'below the greater trochanter Dof the lateral aspect of femoral shaft E, slants upwardly throughfemoral shaft B, then up through the central portion'of femoral neck C,across the site of the fracture B, and into femoral head F. Check X-raysare taken at appropriate times to assure that the guide hole isvproperly located. After the proper guide hole has been drilled then pin11' is screwed into place following the path of the guide hole. When pin11 is in final position its lag-screw end'will be positioned closelyadjacent, such as a distance-of A1 to /8, the articular surface of thecentral portion G of the femoral head F. Pin 11 length that the threadedportion 16. thereof will project outwardly of the femoral shaft B Afterpin 11 is in place that end of jacket 12 which carries the chisel edges22 and 23 is fitted upon. the threaded portion 16 which E. Thereafter,the jacket 12 is driven, by a suitabletool,

into the femur slidably along the pin 11 until. the chisel edges 22 and23 abut the thread 17 on pin 11. will be entirely contained within thefemur, with its inner end in engagement with lag-screw 17 atfemoral headF,

inner base of the lag-screw 'and'its outer end spaced. inward a slightdistance from the exterior surface of femoral shaft E.

After jacket 12 has been? insertedianchor plate 13 is slipped over thethreadedportion 16 of'pin 11 and force applied thereto to press its;attaching prongs 25 intothe bone-of. the femoral shaft E and affixplate-13: firmlyagainst the lateral aspect ofthe femoral shaft E. Nut 14is then threaded onto portion 16 and into hearing engagement with washer13. Nut 14' is of ing type having a conventional internal rubber onfiberinsert whichclosely engages the threads 16. Smcecom.

for.- use mercially available. lock nuts are contemplated herein afurther description is not necessary.

It is preferred, of.

isselected in" an appropriate projects from femoral shaft.

When in final position, jacket 12.

the lock-e It is understood, of course, that pin 11 andtjacket ,12

' will be selected in diameters andlengths which will accommodate theanatomical'size of the femur of the individual .patient. .1 With thevusev'oflXqays it can be readily determined the size ofth bone tobepenetrated,

Wha'tgtheangle' of penetration-should be and how much bone :will' be.requir'edto bespan'ned', and thereafter a pin 5-1'1 'and'a'jacket'J-IZ;of appropriate diameters and (lengths'fcanlie-selected for use. Thelength of pin 11 will eigreater than that of jacket 12 by an amountsufilcient to carry a run of lag-screw thread which will permit firmimplanting of the head of pin 11. A differ ence of approximately an inchof length will effect a useful device.

In its operation, the present nail assembly effects compression forcesacting directly across the fracture site B. With the lag-screw 17 of.pin 11 firmly implanted in the femoral headF and with the anchonpl'atel3 firmly attached to the exterior surface of the femoral shaft E twofixed points are established for effecting internal fixation ofthefractured femoral neck 0; It is apparent thatwiththe tighten'ing'of thedome portion of nut 14 intUbearing' engagement'with ancho ...plate 13that a pulling force is applied tojpin 11 to'produce compressionof th'efracture fragments.

- It is noted that cen'tral opening 24 of plate l3iis sornewhat largerthan'the diameter of pin 11 to readily accommodate the angulardispositionof the pin ll'with respect to plate 13. Since pin 11 passesthrough the central opening 24- of anchor plate 13 any tendency' Withthe use of the present nail assembly 110: any posibility of angular,rotational or torsional forces acting adversely at the fracture: site isvirtually completely obviated. The fracture fragments are lockedtogether and the cellular apposition would be a fixed andmechanicallystable apposition. A g

It is known that compression of bone across a fracture site definitelyenhances and speeds upthe process of bone healing and the present nailassembly lll effectively and efficiently acts to provide desirablecompression forces directly across and through the fracture site.

With hip motion and hip function nail migration often occurs when theusual form of nail is employed in the treatment of fractures tocomplicate the process of healing. By providing solid fixation in boththe distal and proximal fracture fragments and having a locking forceacross the fracture site, the present nail assembly virtually eliminatesany possibility of nail migration, either sideways or longitudinally, todefinitely enhance healing and avoid secondary complications. 7

While certain preferred embodiments of the invention have beenspecifically disclosed it is understood that the invention is notlimited thereto as many variations will be readily apparent to thoseskilled inthe art and the invention is to be given its broadest possibleinterpretationwithin the 'terms of thefollowing'claims.

What I claim is:

1. A fastening device for treating bone fractures comprising anelongated pin having a cylindrical body with a 'conically formed endportion, a thread on'said conically formed end portion, said cylindricalbody having a threaded portion at its opposite end, an elongated sleevemember having a central bore therethrough accommodating said elongatedpin between the ends thereof, said sleeve member havinglaterally'projecting restraining flange means thereon, an anchor plate'fitting on said said opposite end for bearing engagement with saidanchor plate.

2. A fastening device for treating bone fractures comprising anelongated pin having a cylindrical body tapering to a conical point atone end, an external helical thread'on ,said tapered end, an elongatedsleeve member having aibore therethrough, said cylindrical body beingreceived within said bore with the tapered end thereof and the endoppositeprojecting beyond opposite ends ofjsaid sleeve member, v saidsleeve member having a plurality of longitudinally extending, laterallyprojecting 'restrahii'nglflange means, and force applying meansmountedjon said oppositegend of said cylindrical body.

, 3. A fastening device for treating bone fractures comprising anelongated pin. having a cylindrical body with a conically formed endportion, an external helical thread on said endportion, an elongatedsleeve member,

d Sleeve mb hav gener ly cyl ndr c y portion with an axialbortherethrough' accommodating said elongatedpin, said elongatedsleevebeing of shorter en t ia x a ,P n f r em s f the Opposite ends ofi sai d'pin beyond the opposite ends of saidfsleev'e, said l body portion ofsaid sleeve having about thecircumfer- 'wflth esf ura of s awdil ans mdixtend ng i= t9'ta n qi s inar estra a efsfl n es, a fo applying meansmounted on the end of said cylindrical body opposite" v to saidconically' formed end portion.

' 4. A fasteningdevice for treatiri'g hip bone fractures comprising anelongated pin havi'nga, cylindrical body with a conically formed endportion havingian external thread thereon, an elongated sleeve member,said-sleeve member having a generally cylindrical body portion with anaxialbore therethrough accommodating said elongated pin, said elongatedsleev b i g, of shorter length than said pinfor projection of theopposite end's 'of said pin beyond the opposite'ends of said sleeve, aplurality of equi-spaced, longitudinally, extending, laterallyprojecting restraining fianges formed about the circumference of saidbody. portion, said flanges having chisel edges at one of their ends andforce applying means mounted on thefe'ndfof said cylindrical bodyopposite to said comically formed end portion.

5. A fasteningdevice for treating hip bone fracturescomprising'anelongated pin having a. cylindrical body with a conicallyforjme d end portion,1a lag-screw thread on said conically formed endportion, an elongated sleeve member, said sleeve member having agenerally cylindrical body portion with an axial bore therethroughaccommodating said elongated body, said elongated sleeve being ofshorter length than said pin for projection of the opposite ends of saidsleeve, a plurality of equi-spaced, longitudinally co-extensive,laterally projecting restraining flangesformed about the circumferenceof said body portion, the annular rim of. said generally cylindricalbody portion of said sleeve disposed adjacent the lag-screw of said pinbeing in the form of 4 a chisel edge, the ends of .said flanges lyingadjacent cylindrical body at said. oppositefend, and a holding saidannular rim also being in the form of chisel edges, a portion at the endof said cylindrical body of said pin opposite the conically formed endportion thereof being threaded, an anchor plate fitting on pin at saidopposite threaded end portion, said plate having a plurality of prongsprojecting therefrom, and a dome nut threadably carried by said oppositethreaded end portion for hearing engagement with said anchor plate.

References Cited in the file of this patent UNITED STATES PATENTS2,267,925 Johnston Dec. 30, 1941 2,702,543 Pugh et a1. Feb. 22, 19552,801,631 Charnley Aug. 6, 1957 FOREIGN PATENTS 918,531 Germany Sept.30, 1954 1,136,123 France Dec. 22, 1956

